scholarly journals Gluteal Compartment Syndrome After Prolonged Immobilization in Drug Abusers

Cureus ◽  
2020 ◽  
Author(s):  
Anupam K Gupta ◽  
Monica I Burgos ◽  
Miguel Lopez-Viego ◽  
Nir Hus
Keyword(s):  
Compartment Syndrome ◽  
Drug Abusers ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

scholarly journals Gluteal Compartment Syndrome Secondary to Pelvic Trauma

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Fernando Diaz Dilernia ◽  
Ezequiel E. Zaidenberg ◽  
Sebastian Gamsie ◽  
Danilo E. R. Taype Zamboni ◽  
Guido S. Carabelli ◽  
...  
Keyword(s):  
Physical Examination ◽  
Compartment Syndrome ◽  
Drug Users ◽  
Pelvic Ring ◽  
Pelvic Trauma ◽  
Intracompartmental Pressure ◽  
Permanent Disability ◽  
Delay In Diagnosis ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

Gluteal compartment syndrome (GCS) is extremely rare when compared to compartment syndrome in other anatomical regions, such as the forearm or the lower leg. It usually occurs in drug users following prolonged immobilization due to loss of consciousness. Another possible cause is trauma, which is rare and has only few reports in the literature. Physical examination may show tense and swollen buttocks and severe pain caused by passive range of motion. We present the case of a 70-year-old man who developed GCS after prolonged anterior-posterior pelvis compression. The physical examination revealed swelling, scrotal hematoma, and left ankle extension weakness. An unstable pelvic ring injury was diagnosed and the patient was taken to surgery. Measurement of the intracompartmental pressure was measured in the operating room, thereby confirming the diagnosis. Emergent fasciotomy was performed to decompress the three affected compartments. Trauma surgeons must be aware of the possibility of gluteal compartment syndrome in patients who have an acute pelvic trauma with buttock swelling and excessive pain of the gluteal region. Any delay in diagnosis or treatment can be devastating, causing permanent disability, irreversible loss of gluteal muscles, sciatic nerve palsy, kidney failure, or even death.

scholarly journals Missed positional gluteal compartment syndrome in an obese patient after foot surgery: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Rami Khalifa ◽  
Madison R. Craft ◽  
Aaron J. Wey ◽  
Ahmed M. Thabet ◽  
Amr Abdelgawad
Keyword(s):  
Compartment Syndrome ◽  
Alcohol Intoxication ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Herniated Disc ◽  
Foot Surgery ◽  
Presumptive Diagnosis ◽  
Increased Risk ◽  
Prolonged Immobilization ◽  
Gluteal Compartment Syndrome

Abstract Background Gluteal compartment syndrome is an uncommon condition and can be difficult to diagnose. It has been diagnosed after trauma, vascular injury, infection, surgical positioning, and prolonged immobilization from drug or alcohol intoxication. The diagnosis is based on clinical findings and, in most cases, recognizing these symptoms and making a diagnosis early is critical to a complete recovery. Case presentation A 53-year-old male who underwent left foot surgery had severe pain to his contralateral hip and posterior gluteal compartment radiating to the right lower extremity immediately postoperative. He was positioned supine with a “bump” placed under his right hip to externally rotate his operative leg during the surgery. Due to the patient’s complex past medical history, a presumptive diagnosis of a herniated disc and/or compression of the sciatic nerve was made as a cause for the patient’s pain. This resulted in a misdiagnosis period of 36 h until the patient was diagnosed with unilateral gluteal compartment syndrome. Performing a fasciotomy was decided against due to the increased risk of complications. The patient was treated with administration of IV fluids and closely monitored. On post-op day 6, the patient was discharged. At three months post-op, the patient was walking without a limp and he had no changes in his peripheral neurologic examination compared to his preoperative baseline. Conclusion Gluteal compartment syndrome is a surgical emergency that must be considered postoperatively especially in obese patients with prolonged operation times who experience acute buttock pain. The use of positional bars or “bumps” in the gluteal area should be used with caution and raise awareness of this complication after orthopedic surgeries.

Complete Bilateral Brachial Plexus Injury from Rhabdomyolysis and Compartment Syndrome: Surgical Case Report

2018 ◽  
Vol 17 (2) ◽  
pp. E68-E72 ◽  
Author(s):  
Daniel A Tonetti ◽  
Ivan S Tarkin ◽  
Kiran Bandi ◽  
John J Moossy
Keyword(s):  
Brachial Plexus ◽  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Brachial Plexus Injury ◽  
Laboratory Data ◽  
Surgical Decompression ◽  
Sensory Function ◽  
Resonance Imaging ◽  
Pectoralis Muscles ◽  
Prolonged Immobilization

Abstract BACKGROUND AND IMPORTANCE Acute bilateral brachial plexus injury is rare and usually a result of traction injury. Immediate operative intervention is reserved for rare cases of ongoing compression of the plexus; the role for acute decompression of the brachial plexus secondary to compartment syndrome has not been previously described. In this report, we describe the technique and role for urgent brachial plexus decompression. CLINICAL PRESENTATION A 32-yr-old man presented with acute complete bilateral brachial plexus palsy due to focal rhabdomyolysis and brachial plexus compression after a night of excess alcohol and methadone ingestion. He had complete loss of motor and sensory function from C5 to T1, with the exception of partial sensory sparing of the C5 dermatome. Magnetic resonance imaging demonstrated diffuse muscular edema of the supraclavicular and infraclavicular fossae in addition to the pectoralis muscles and the deltoids bilaterally. He underwent urgent surgical decompression of his supraclavicular and infraclavicular fossae with fasciotomies of the pectoral muscles and the anterior deltoids, allowing direct visualization and decompression of the entire brachial plexus resulting in a near-complete functional recovery. CONCLUSION Neurosurgeons should include brachial plexus compression due to compartment syndrome in the differential diagnosis of patients with acute upper extremity weakness, particularly when associated with prolonged immobilization and/or substance abuse. Prompt surgical decompression should be performed in these patients if imaging and laboratory data suggest compartment syndrome and resultant neurological deficit.

scholarly journals A Pain in the Butt: A Case Series of Gluteal Compartment Syndrome

2021 ◽  
Vol 2 (5) ◽  
pp. 144-147
Author(s):  
Jessica Jackson ◽  
Kraftin Schreyer
Keyword(s):  
Compartment Syndrome ◽  
Clinical Presentation ◽  
Case Series ◽  
Morbidity And Mortality ◽  
Emergency Physicians ◽  
Laboratory Findings ◽  
Diagnosis And Management ◽  
Gluteal Compartment Syndrome

Introduction: Gluteal compartment syndrome is a rare and difficult-to-diagnose form of compartment syndrome. Case Series: We present three patients with gluteal compartment syndrome and review the clinical presentation, imaging, and laboratory findings that assist in diagnosis. Suggestions for more readily diagnosing gluteal compartment syndrome are provided. Conclusion: Emergency physicians must be familiar with the diagnosis and management of gluteal compartment syndrome to prevent the significant associated morbidity and mortality.

scholarly journals Delayed Presentation of Gluteal Compartment Syndrome: The Argument for Fasciotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
John E. Lawrence ◽  
Duncan J. Cundall-Curry ◽  
Kuldeep K. Stohr
Keyword(s):  
Compartment Syndrome ◽  
Kidney Injury ◽  
Limb Ischaemia ◽  
Delayed Presentation ◽  
Neurological Improvement ◽  
Tertiary Centre ◽  
Acute Limb Ischaemia ◽  
Nerve Recovery ◽  
The Right ◽  
Gluteal Compartment Syndrome

A male patient in his fifties presented to his local hospital with numbness and weakness of the right leg which left him unable to mobilise. He reported injecting heroin the previous morning. Following an initial diagnosis of acute limb ischaemia the patient was transferred to a tertiary centre where Computed Tomography Angiography was reported as normal. Detailed neurological examination revealed weakness in hip flexion and extension (1/5 on the Medical Research Council scale) with complete paralysis of muscle groups distal to this. Sensation to pinprick and light touch was globally reduced. Blood tests revealed acute kidney injury with raised creatinine kinase and the patient was treated for rhabdomyolysis. Orthopaedic referral was made the following day and a diagnosis of gluteal compartment syndrome (GCS) was made. Emergency fasciotomy was performed 56 hours after the onset of symptoms. There was immediate neurological improvement following decompression and the patient was rehabilitated with complete nerve recovery and function at eight-week follow-up. This is the first documented case of full functional recovery following a delayed presentation of GCS with sciatic nerve palsy. We discuss the arguments for and against fasciotomy in cases of compartment syndrome with significant delay in presentation or diagnosis.

Delayed Presentation of Gluteal Compartment Syndrome due to Pseudoaneurysm Rupture

2019 ◽  
Vol 9 (3) ◽  
pp. e0346-e0346
Author(s):  
Matthew J. Braswell ◽  
Ashley Anderson ◽  
Michael Donohue ◽  
Michelle C. DiVito ◽  
Paul W. White ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Delayed Presentation ◽  
Gluteal Compartment Syndrome

Bilateral Gluteal Compartment Syndrome: A Rare but Potentially Morbid Entity

2010 ◽  
Vol 76 (7) ◽  
pp. 752-754 ◽  
Author(s):  
Jose Castro-Garcia ◽  
Brian R. Davis ◽  
Miguel A. Pirela-Cruz
Keyword(s):  
Compartment Syndrome ◽  
Operating Room ◽  
Illicit Drug ◽  
Early Recognition ◽  
Lumbar Pain ◽  
Interstitial Pressure ◽  
Sensory Deficits ◽  
Illicit Drug Abuse ◽  
The Right ◽  
Gluteal Compartment Syndrome

Compartment syndrome is caused by elevated interstitial pressure within the myofascial compartment. It rarely presents bilaterally in the gluteal region. A 49-year-old man fell 10 feet from a roof on his buttocks. He presented 10 hours after the injury with intense lumbar pain. Both glutei were exceptionally tense. There were no vascular injuries or sensory deficits. Compartmental pressures measured 60 mm Hg on the left side and 50 mm Hg on the right side. The patient was taken to the operating room for decompressive fasciotomy. The glutei compartments were released. He was taken once more to the operating room, requiring only minimal debridement. He was discharged the next week with no neurological deficit. Bilateral gluteal compartment syndrome is very rare with few cases reported in the literature. It has been associated with trauma, prolonged recumbence, surgical instrumentation, and illicit drug abuse. Early recognition is required to avoid the potential severe metabolic and physical deficits.

Bilateral Gluteal Compartment Syndrome

1997 ◽  
Vol 42 (1) ◽  
pp. 118-122 ◽  
Author(s):  
Richard J. Bleicher ◽  
Harold F. Sherman ◽  
Barbara A. Latenser
Keyword(s):  
Compartment Syndrome ◽  
Gluteal Compartment Syndrome
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